Healthcare Provider Details

I. General information

NPI: 1639681083
Provider Name (Legal Business Name): LASHAUNA LATIA BANKS-CHATMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2017
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 W UNIVERSITY AVE STE B
GAINESVILLE FL
32601-5678
US

IV. Provider business mailing address

10462 SW 132ND CT
DUNNELLON FL
34432-4945
US

V. Phone/Fax

Practice location:
  • Phone:
  • Fax:
Mailing address:
  • Phone: 352-871-0127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: